Organization
SOMERVILLE DIALYSIS CENTER LLC
Active
Other names
Galleria Home Training Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL T WEY (SR DIRECTOR LICENSURE&CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
9045 US HIGHWAY 64, STE 102, LAKELAND, TN 38002-8394
(901) 213-2955
(901) 213-1724
Mailing address
5200 VIRGINIA WAY, L&C DEPT, BRENTWOOD, TN 37027-7569
(615) 320-4514
(866) 594-9961
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0442678
—
TN
05
—
08377719
—
MS
05
—
177215134
—
AR
Enumeration date
02/08/2008
Last updated
08/17/2023
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